| NPI | 1447412952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: NJ 25MA09441300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT193436) |
| 207W00000X Ophthalmology (Licence: WA MD60191039) | |
| 207W00000X Ophthalmology (Licence: CT 051639) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA09441300) | |
| 207W00000X Ophthalmology (Licence: PA MD453009) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2016-05-04 |